Individual
GARY A. KOENIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1120 N 103RD PLZ, SUITE 102, OMAHA, NE 68114-1114
(402) 354-0120
(402) 354-0125
Mailing address
PO BOX 3755, OMAHA, NE 68103-0755
(402) 354-2100
(402) 354-6171
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
17844
NE
207K00000X
Allergy & Immunology Physician
23943
IA
207R00000X
Internal Medicine Physician
17844
NE
207R00000X
Internal Medicine Physician
23943
IA
207RP1001X
Pulmonary Disease Physician
17844
NE
207RP1001X
Pulmonary Disease Physician
23943
IA
207RS0012X
Sleep Medicine (Internal Medicine) Physician
17844
NE
207RS0012X
Sleep Medicine (Internal Medicine) Physician
23943
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10026480109
—
NE
05
—
1942204656
—
IA
Enumeration date
06/09/2005
Last updated
08/22/2016
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